Stump

Stump - part of a limb, remaining after the amputation or formed as a result of its congenital underdevelopment. The stump is also called the balance nerve or bronchus after transection, vermiform process after its removal, etc. Stump limbs are distinguished by the length (feet, legs, hips, fingers, hands, forearms, shoulderand upper, middle and lower third of the segment in form (conic, cylindrical and clavate; functions - full mobility in joints, limited mobility due to contractures (see) and the lack of mobility as a result of frets (see).
Conical stump narrows rapidly to an end in the form of a cone due to sharp atrophy of muscles, and fatty tissue. Cylindrical stump is shaped like a cylinder with a slight restriction to its end; clavate stump has thickening at the end (Fig. 1).
When assessing the stump and the possibility of prosthesis should be considered its form and function.
Stump feet are in the field hocks and Tarsus. When the cult hocks gait unchanged or slightly disturbed. After an amputation tarsal break the arch of the foot and load falls on the end stump (see Stop). It causes pain when walking and installs the stump in the position of a horse's feet (Fig. 2). The defect of the foot well compensated orthopedic shoes. The presence of stumps of both feet, especially when painful scars, trophic disorders, ulcers, accompanied by a persistent limitation of ability to work and leads to disability (group III).


Fig. 1. Clavate (left) and cylindrical (right) shank stump. Fig. 2. Stump in the position of a horse's foot. Fig. 3. Deformation overly short stump due to the deviation of the fibula.

Shank stump. Their length in the upper third - 13 cm, and in short, in the average - from 26 to 13 cm, at the bottom - from the 26 cm and longer. Most adverse long stump, reaching the bottom third. Due to the poor blood flow to this part of the Shin here often develop trophic disorders and formed an open ulcer, which leads to reamputation.
Short stump (6-4 cm or less) significantly complicate prosthetics, as this develops a kind of deformation - deviation fibula outwards (Fig. 3).
After correctly made the amputation of a limb defect can be well compensated prosthesis, this gait is no different from normal. Even after the amputation of both legs can a normal walking, and sometimes skating, skiing, dancing. When the cult of one leg establish III disability group, with stumps of both shins - II group.
Stump hips. After the amputation hip defect limb cannot be sufficiently compensated by the prosthesis, so gait is always different from normal.
Trophic violations stump hips are much less common than lower leg, and depend mainly on the poor fit of the prosthesis socket. As a rule, when the cult of one thigh establish III disability group, but when short residual (less than 8 cm), illnesses and diseases stump preventing prosthetics - II disability group. The most difficult conditions created after the amputation of both hips.
The movement in prostheses difficult, which requires the assignment of disability group II, and after the amputation in the upper third of the thigh - the first group.
Stump fingers and hand. The brush has six types of capture: pliers, flat, spherical, cylindrical, "sculpture" and a hook. Most of the functions of the self catering is provided, she grip (holding pen, pencil, spoon, fork, knife). After uninstalling I finger becomes impossible pliers capture and difficult sculpture. This disrupts the function of the hand when working, which is connected with the necessity of a complete takeover. With the loss of the first finger on both hands function brush violated even more, which leads to permanent limitation of ability to work; establish III disability group.
The absence of all the fingers on both hands disables the person; set II disability group. If such defects appropriate operation of talangsari (see);
Stump forearm - in the upper third of 8 cm and shorter average - from 8 to 16 cm and the lower 16 cm and longer. In the absence of a single brush set III disability group. After the amputation of both clusters need of outside care and maintenance; set of I disability group. The use of work prosthesis designs Latina enables disabled persons deprived parts of the forearm, return to work in their specialty (carpenter, a mechanic, Turner and others).
Stump shoulder in the upper third of the 10 cm shorter average from 10 to 20 cm and bottom - 20 cm and longer. After the amputation shoulder function hands completely falls, good hand, to some extent compensates for the missing; establish III disability group; in the absence of both hands at shoulder level - the I group. Suitable prosthesis active prostheses.
Cm. also Prosthetics.